A web-based surveillance model of eosinophilic meningitis: future prediction and distribution patterns

Background: web-based surveillance is a useful tool for predicting future cases of various emerging infectious diseases. There are limited data available on web-based surveillance and patterns of distribution of eosinophilic meningitis (EOM), which is an emerging infectious disease in various countries around the world.  Methods: this study applied web-based surveillance to the prediction of EOM incidence and the analysis of its distribution pattern by using a national database, which may be used for future prevention and control. The number cases of EOM in each month over a period of 12 years (between 2006 to 2017) from Loei province were retrieved from the National Disease Surveillance (Report 506) website, operated by Thailand's Public Health Center.  Results: we developed autoregressive integrated moving average (ARIMA) models and seasonal ARIMA (SARIMA) models. The best model was used for predicting numbers of future cases. The forecast values from the SARIMA (1, 1, 2)(0,1,1)6 model were close to actual values and were the most valid, as they had the lowest RMSE and AIC. The predictive model for future cases of EOM was related to previous numbers of EOM cases over the past eight months. The disease exhibited a seasonal pattern during the study period.  Conclusions: web-based surveillance can be used for future prediction of EOM, that the predictive model applied here was valid, and that EOM exhibits a seasonal pattern

Continuous positive airway pressure therapy converted atrial fibrillation in a patient with obstructive sleep apnea

AbstractBackgroundObstructive sleep apnea (OSA) is one of the possible causes of atrial fibrillation (AF). Continuous positive airway pressure (CPAP) therapy may lower the recurrence rate of AF after cardioversion to normal sinus rhythm. We report a case of AF caused by OSA and successfully converted by CPAP therapy.CaseA 65-year-old man presented with AF of unidentified causes. After severe OSA was diagnosed, he was treated with CPAP for 2 months and his cardiac rhythm returned to sinus rhythm without any antiarrhythmic drugs or cardioversion.ConclusionAF caused by OSA may be converted to sinus rhythm by CPAP treatment

Additional risk factors associated with symptomatic hydrochlorothiazide-induced hyponatremia in hypertensive patients

Background. Hydrochlorothiazide is a cheap and effective antihypertensive agent but may cause hyponatremia. Even though several risk factors for hydrochlorothiazide-induced hyponatremia have been reported, this study aimed to evaluate additional risk factors for hydrochlorothiazide-induced hyponatremia in hypertensive patients. Material and methods. The inclusion criteria were: adult patients, diagnosed with hypertension and receiving hydrochlorothiazide treatment. Eligible patients were divided into two groups: with and without hyponatremia. Those with hyponatremia were identified by using the ICD-10 code E871, while those without hyponatremia were patients who did not have any reported hyponatremia until the last visit. The ratio between hyponatremia and non-hyponatremia group was 1:2. Predictors for hyponatremia were analyzed by using logistic regression analysis. Results. During the study period, there were 68 patients admitted due to symptomatic hyponatremia from hydrochlorothiazide. There were four independent factors in the model predictive of occurrence of symptomatic hydrochlorothiazide-induced hyponatremia in hypertensive patients: sex, body mass index, plasma glucose, and serum albumin. Male sex, body mass index, and serum albumin were negatively associated with occurrence of symptomatic hydrochlorothiazide-induced hyponatremia in hypertensive patients with adjusted OR of 0.099, 0.683, and 0.122, respectively. The plasma glucose had adjusted OR of 1.030 [95% CI of (1.009, 1.051)]. Conclusions. Factors associated with hydrochlorothiazide-induced symptomatic hyponatremia in hypertensive patients were sex, body mass index, plasma glucose level, and serum albumin level. The latter two risk factors have never been reported as risk factors for hydrochlorothiazide-induced symptomatic hyponatremia in hypertensive patients

Prevalence of Geriatric Syndromes in Elderly Cancer Patients Receiving Chemotherapy

The number of elderly patients with cancer is growing. Our study goals were to determine the prevalence of geriatric syndromes in elderly cancer patients receiving chemotherapy and its related factors using a basic geriatric screening tool. A cross-sectional study using the basic geriatric screening tool was conducted to survey geriatric problems in a population of elderly cancer patients receiving chemotherapy. There were 85 participants who were ≥60 years old. Descriptive statistics and regression analyses were used. The prevalence of having at least one geriatric syndrome was 58.8% (50 out of 85 cases). Depression was the most common component both in male and female patients. Age ≥65 years old was significantly associated with the geriatric syndrome (AOR 4.23, p=0.018), and a factor associated with depression was underweight (BMI<18.5 kg/m2) (AOR 13.2, p=0.003). In summary, geriatric syndromes are common in elderly cancer patients. Screening for geriatric syndrome adds substantial data on the assessment of elderly cancer patients, even those with a good performance status

The impact of skeletal muscle mass on survival outcome in biliary tract cancer patients.

Low skeletal muscle mass is frequently observed in cancer patients and is known to be a poor prognostic factor for survival outcomes. The purposes of our study were to determine the prevalence of sarcopenia and its relation to mortality in biliary tract cancer. Body composition measurements (skeletal muscle index, total fat mass, bone mineral content) were evaluated by using dual-energy x-ray absorptiometry in 75 biliary tract cancer patients before chemotherapy. Muscle strength was measured by handgrip strength and gait speed. Overall survival and its associated factors were determined. The mean appendicular muscle mass was 17.8±2.7 kg in men and 14.0±2.1 kg in women (p < 0.05). Sarcopenia was diagnosed in 46 patients (61.3%) and higher proportion of men was classified as sarcopenia than women (69.0% vs 35.3%, p < 0.05). Multivariable analysis adjusted for chemotherapy regimen and age revealed that high appendicular muscle mass independently predicted better survival outcomes (HR 0.40; 95% CI, 0.18 to 0.88; p = 0.023). Sarcopenia is common in biliary tract cancer patients and low appendicular muscle mass was associated with poor survival outcome

Prevalence and risk factors for persistent atrial fibrillation in obstructive sleep apnea

Objectives: Obstructive sleep apnea (OSA) is a common cause of atrial fibrillation (AF). The prevalence rate of OSA in AF is highest at 80%. There is limited data if who will develop AF in OSA patients. This study aimed to evaluate the prevalence of AF in patients with OSA and find clinical factors predictive of AF in patients with OSA. Material and Methods: This was a cross-sectional study. We enrolled consecutive patients diagnosed with obstructive sleep apnea diagnosed by polysomnography. The primary outcome was persistent AF identified by electrocardiogram. Prevalence and predictors of AF in patients with OSA were analyzed. Results: During the study period, there were 199 patients with OSA enrolled in the study. Of those, 31 patients (15.57%) had AF. There were five factors in the final model predictive for AF in OSA patients. Among those factors, three factors were independently associated with AF in OSA including age, tiredness, and glomerular filtration rate. The latter two factors were protective factors, while age was a predictor for AF with an adjusted odds ratio (95% confidence interval) of 1.052 (1.004, 1.103). Conclusion: The prevalence of AF in patients with OSA was 15.57%. Elderly patients with renal deterioration are at risk of AF but AF risk was decreasing in patients with tiredness

National Data of CPR Procedures Performed on Hospitalized Thai Older Population Patients

Background: Little is known about the epidemiology of the elderly who receive cardiopulmonary resuscitation (CPR) and the subsequent survival factors in Thailand and other developing countries. The objective of this study was to determine the rate of CPR and the survival rate among hospitalized Thai elderly patients, and also factors predicting survival at discharge. Methods: National databases from three sources were searched. These three systems accounted for 96% of the Thai population. All inpatients in the fiscal year 2010 (from October 1, 2009 to September 31, 2010) aged 60 years or over who received CPR procedure were included. Baseline characteristics were studied. The study outcomes were CPR rate, mortality rate, and survival factors. Results: In total, 17,813 elderly patients who were hospitalized during the 2010 fiscal year received CPR (997.2/100,000 older adults). Of those, 5125 patients (28.77%) survived at discharge. Pre-existing comorbidity, asystole, time on a mechanical ventilator > 96 hours, and being admitted to a private hospital were associated with poorer outcomes (p < 0.05). Conclusion: The rate of CPR in hospitalized elderly patients was 997.2 events/100,000 older adults with a survival rate of 28.77%. Factors predicting death at discharge are pre-existing comorbidities, cardiac arrhythmia type, intervention/procedure, and type of hospital

Malignant Mesothelioma of the Pericardium: A Report of Two Different Presentations

Malignant mesothelioma of the pericardium is a rare and fatal condition that clinicians should be aware of due to its variability of clinical manifestation. The diagnosis may be delayed as a result of delayed treatment. Here, we report two cases of malignant pericardial mesothelioma with two different clinical aspects: cardiac tamponade and mimic tuberculous pericarditis. Both patients: may have indirect exposure to asbestos. Despite chemotherapy, both patients died at 2 weeks and 3 months after the diagnosis. Malignant mesothelioma of the pericardium is fatal, has a variety of presentation, and may not be related to asbestosis exposure